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Post-diagnostic dementia care is often fragmented in the United Kingdom, with great variation in provision. Recent policies suggest moving towards better community-based care for dementia; however, little is known on how this care is delivered. This study aimed to map the post-diagnostic dementia support provided in England a decade after the introduction of a National Dementia Strategy.

A mixed-methods e-survey (open Nov 2018–Mar 2019) of dementia commissioners in England recruited through mailing lists of relevant organisations was conducted. The authors descriptively summarised quantitative data and carried out thematic analysis of open-ended survey responses.

52 completed responses were received, which covered 82 commissioning bodies, with representation from each region in England. Respondents reported great variation in the types of services provided. Information, caregiver assessments and dementia navigation were commonly reported and usually delivered by the voluntary sector or local authorities. Integrated pathways of care were seen as important to avoid overlap or gaps in service coverage. Despite an increasingly diverse population, few areas reported providing dementia health services specifically for BME populations. Over half of providers planned to change services further within five years.

There is a need for greater availability of and consistency in services in post-diagnostic dementia care across England.

Post-diagnostic dementia care remains fragmented and provided by a wide range of providers in England.

Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental health and other problems. This article sets out some of the challenges facing planners and commissioners in developing integrated services for older adults, by using the case study of people with dementia and incontinence problems. It uses integrated service models and observations from the EVIDEM‐C study to suggest some incremental actions that would help develop the long‐term strategy for integrated services.

Behavioural and psychological symptoms of dementia (BPSD) are a far too common and disturbing occurrence for people with dementia, their families and those who care for them. The consequences can be not only devastating personally and challenging professionally, but also costly for service providers. In this, the fourth of this series on older people's mental health services, we describe what BPSD are, what we know about current service provision for this group and the gaps, and how commissioners might approach these issues when developing services for older people with dementia.

Mental health problems in later life are common and damaging experiences for individuals, their families and those who support them. Some become almost the defining feature of the older person and, while they are challenging professionally and costly for society, they are also influenced by the twin discriminations of stigma and ageism. In this, the last in our series on older people's mental health, we pull together some other key messages from the series and set them in the context of current and future service commissioning and provision. We point to remaining gaps in provision and suggest how commissioners might approach the problems of mental ill‐health in later life in a context of declining resources.

Local authorities and primary care trusts receive regular instructions to put new legislation into practice, and to ensure appropriate training. This article takes the implementation of the Mental Capacity Act as a case study of how commissioners are involved in such changes, and reports on two models. The MCA is an example of the gains that can be made if commissioners think about implementation across agencies, and between public and private sectors.

The second in a new series about mental health in old age, this article reviews policies and research evidence on services for people with dementia at the end of their lives, and looks at future commissioning priorities

An overview of the impact of dementia that focuses on underdeveloped countries across the globe, and migrant and minority ethnic communities within the developed world. Increased longevity increases the risk of dementia and brings new challenges in terms of cultural perspectives and cultural obligations in the care of elders. The chapter examines these challenges in detail and their consequences in planning for support and care.